Sometimes, no matter what you do, you can’t lose weight. The reasons why may surprise you.

It’s no surprise that a diet with lots of fried foods, sugary desserts, alcohol, soft drinks, and the like will lead to weight gain.

However, if you’ve been following a healthy diet and exercising regularly but are consistently gaining weight, it’s time to find out why.

“If you are gaining weight while watching calories and being physically active, the pounds could be coming from a physical condition, hormonal shifts, or the medications you take,” according to Sari Greaves, a registered dietitian in private practice in New York City and a spokeswoman for the American Dietetic Association.

Unexplained weight gain can have multiple causes, including the following.

Decrease in Metabolism
Metabolism is determined by gender, age, calorie intake, amount of muscle compared to body fat, and amount of exercise and physical activity.

“So if you’ve decreased the amount of physical activity you get per week, your metabolism—the amount of calories you need per day—can drop, even though you haven’t changed your diet,” Greaves explains.

And if you think skipping meals or severely restricting your calorie intake will help you lose weight, think again.

“Both of these behaviors can cause weight gain because doing so slows down metabolism,” she says.

Finally, because your metabolism decreases as you age, if you are age 40 or older and consuming the same amount of food you did in your 20s, you’ll have extra pounds to show for it.

Medication Use
Medications can cause a variety of side effects, one of which is weight gain that can add up to as much as a pound a week.

Common prescription medications that can add pounds include some that treat depression, heartburn, migraines, seizures, bipolar disorder, high blood pressure, and diabetes, as well as birth control pills and corticosteroids.

Some over-the-counter drugs—including antihistamines, anti-inflammatories, and sleeping pills—can add pounds if taken regularly.

If you suspect medication is behind your weight gain, call your doctor and see if your medication or your dosage could be changed.

Illness
Weight gain can be a symptom of the following conditions:

• Depression. Sometimes this condition causes an increase in appetite.
• Hypothyroidism. This condition causes a deficiency in the thyroid hormones leading to fatigue, weight gain, and slowed metabolism.
• Polycystic ovary syndrome. This condition can gradually cause a weight gain of up to 30 pounds over a period of years.
• Sleep apnea. Not getting enough sleep can lead to the slowing of metabolism.
• Kidney, heart, or liver disease. Disease in these organs can cause fluid retention.

Hormonal Changes
Female hormones can cause weight gain for these reasons:

• Menstrual water retention. Many women experience bloating before and during their menstrual cycles.
• Menopause. The hormonal changes that accompany menopause can trigger hunger, poor sleep, and decreased metabolism.

The bottom line:

“Most weight gain is caused by eating too much and exercising too little,” Greaves says. “But if you’re doing everything right and still adding pounds, something else may be going on.”

Barbara Floria spoke with Sari Greaves, a registered dietician in private practice in New York City and a spokeswoman for the American Dietetic Association. For more information, visit www.eatright.org.

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